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Short-Term Impact of Hematopoietic Stem Cell Transplantation on Depressive Behavior, Cognition and Quality of Life in Leukemia Patients

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Abstract

Hematopoietic stem cell transplantation (HSCT) or Bone Marrow Transplantation (BMT) has significantly improved the survival rates of patients suffering from hematological malignancies. However, the cure can only be achieved at the price of morbidity and long-term complications. Thus, this study aimed to evaluate the short-term effect of HSCT on depressive behavior, cognition, and quality of life (QoL) in leukemia patients. Sixty patients were included in this prospective observational study. The current study assessed depression using Patient Health Questionnaire (PHQ-9) scale, cognition using Montreal Cognitive Assessment (MOCA) scale and QoL using European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30) before 7 days of the therapy i.e., preconditioning/baseline (TP1) and after 30 days of the treatment (TP2) in leukemia patients undergoing HSCT. At TP2, there was a significant improvement in PHQ-9 (p = 0.001), MOCA (p < 0.0001), functional scale (p < 0.0001) and global health & QoL scale (p = 0.001) of EORTC QLQ C30 scores whereas there was a significant decrease in symptom scale of EORTC QLQ C30 score (p = 0.005). Furthermore, at TP2 a statistically significant (p < 0.05) negative correlation was observed between MOCA and symptom scale of EORTC QLQ C30 after Pearson correlation analysis. In conclusion, post-30 days of HSCT there was alleviation in depressive behavior, cognition, and QoL in leukemia patients compared to before therapy.

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References

  1. Kohrt HE, Pillai AB, Lowsky R, Strober S (2010) NKT cells, Treg, and their interactions in bone marrow transplantation. Eur J Immunol 40:1862–1869. https://doi.org/10.1002/eji.201040394

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Park H, Byun JM, Koh Y et al (2019) Comparison of different conditioning regimens in allogeneic hematopoietic stem-cell transplantation shows superiority of total body irradiation-based regimen for younger patients with acute leukemia: a nationwide study. Clin Lymphoma Myeloma Leuk 19:e605–e615. https://doi.org/10.1016/j.clml.2019.08.005

    Article  PubMed  Google Scholar 

  3. Gerritsen W (1986) Allogeneic bone marrow transplantation. Leuk Res 10:77–78. https://doi.org/10.1016/0145-2126(86)90110-4

    Article  Google Scholar 

  4. Andersson I (2009) Health-related quality of. Life 32:325–334

    Google Scholar 

  5. Andersson I, Ahlberg K, Stockelberg D, Persson LO (2011) Patients’ perception of health-related quality of life during the first year after autologous and allogeneic stem cell transplantation. Eur J Cancer Care Engl 20:368–379. https://doi.org/10.1111/j.1365-2354.2009.01174.x

    Article  CAS  PubMed  Google Scholar 

  6. Buchbinder D, Kelly DL, Duarte RF et al (2018) Neurocognitive dysfunction in hematopoietic cell transplant recipients: expert review from the late effects and quality of life working committee of the CIBMTR and complications and quality of life working party of the EBMT. Bone Marrow Transpl 53:535–555. https://doi.org/10.1038/s41409-017-0055-7

    Article  CAS  Google Scholar 

  7. Seo HJ, Baek YG, Cho BS et al (2019) Anxiety and depression of the patients with hematological malignancies during hospitalization for hematopoietic stem cell transplantation. Psychiatr Investig 16:751–758

    Article  Google Scholar 

  8. Beglinger LJ, Duff K, Van Der Heiden S et al (2007) Neuropsychological and psychiatric functioning pre- and posthematopoietic stem cell transplantation in adult cancer patients: a preliminary study. J Int Neuropsychol Soc 13:172–177. https://doi.org/10.1017/S1355617707070208

    Article  PubMed  Google Scholar 

  9. Booth-Jones M, Jacobsen PB, Ransom S, Soety E (2005) Characteristics and correlates of cognitive functioning following bone marrow transplantation. Bone Marrow Transpl 36:695–702. https://doi.org/10.1038/sj.bmt.1705108

    Article  CAS  Google Scholar 

  10. Bosco A, Spano G, Caffò AO et al (2017) Italians do it worse. montreal cognitive assessment (MoCA) optimal cut-off scores for people with probable Alzheimer’s disease and with probable cognitive impairment. Aging Clin Exp Res 29:1113–1120. https://doi.org/10.1007/s40520-017-0727-6

    Article  PubMed  Google Scholar 

  11. Baekelandt BMG, Fagerland MW, Hjermstad MJ et al (2019) Survival, complications and patient reported outcomes after pancreatic surgery. HPB (Oxford) 21:275–282. https://doi.org/10.1016/j.hpb.2018.07.023

    Article  PubMed  Google Scholar 

  12. Holtan SG, Majhail NS, Weisdorf DJ (2018) Complications after hematopoietic cell transplantation. In: Hematology: basic principles and practice. 1669–1684.e2

  13. Jim HSL, Sutton SK, Small BJ et al (2016) Trajectories of quality of life after hematopoietic cell transplantation: secondary analysis of blood and marrow transplant clinical trials network 0902 data. Biol Blood Marrow Transplant 22:2077–2083. https://doi.org/10.1016/j.bbmt.2016.08.012

    Article  PubMed  PubMed Central  Google Scholar 

  14. Grulke N, Albani C, Bailer H (2012) Quality of life in patients before and after haematopoietic stem cell transplantation measured with the European organization for research and treatment of cancer (EORTC) quality of life core questionnaire QLQ-C30. Bone Marrow Transpl 47:473–482

    Article  CAS  Google Scholar 

  15. Bryant AL, Walton AL, Shaw-kokot J et al (2015) P atien t-R ep o rted sym ptom s and Q u a lity o f life in adults W ith acute Leukem ia: a system atic R eview. Oncol Nurs Soc 42:91–102

    Google Scholar 

  16. Palmer J, Kosiorek HE, Wolschke C et al (2019) Assessment of quality of life following allogeneic stem cell transplant for myelofibrosis. Biol blood marrow Transplant J Am Soc Blood Marrow Transplant 25:2267–2273. https://doi.org/10.1016/j.bbmt.2019.07.001

    Article  Google Scholar 

  17. Tyagi K, Masoom M, Majid H et al (2022) Role of cytokines in chemotherapy related cognitive impairment of breast cancer patients: a systematic review. Curr Rev Clin Exp Pharmacol. https://doi.org/10.2174/2772432817666220304212456

    Article  Google Scholar 

  18. Gheihman G, Zimmermann C, Deckert A et al (2016) Depression and hopelessness in patients with acute leukemia: the psychological impact of an acute and life-threatening disorder. Psychooncology 25:979–989. https://doi.org/10.1002/PON.3940

    Article  PubMed  Google Scholar 

  19. Williams A, Yarosh R, Clark J, et al (2018) Correlates of anxiety and depression in chronic lymphocytic leukemia (CLL) survivors. 101200/JCO2018367_suppl153 36:153–153. https://doi.org/10.1200/JCO.2018.36.7_SUPPL.153

  20. Turhan AB, Tülin Fidan S, Yarar C et al (2018) Neurocognitive consequences of childhood leukemia and its treatment. Indian J Hematol Blood Transfus 34:62. https://doi.org/10.1007/S12288-017-0846-4

    Article  PubMed  Google Scholar 

  21. Williams ALM, van Wijngaarden E, Seplaki CL et al (2020) Cognitive function in patients with chronic lymphocytic leukemia: a cross-sectional study examining effects of disease and treatment. Leuk Lymphoma 61:1627. https://doi.org/10.1080/10428194.2020.1728748

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lofstad GE, Reinfjell T, Weider S et al (2019) Neurocognitive outcome and compensating possibilities in children and adolescents treated for acute lymphoblastic leukemia with chemotherapy only. Front Psychol 10:1027. https://doi.org/10.3389/FPSYG.2019.01027/BIBTEX

    Article  PubMed  PubMed Central  Google Scholar 

  23. Svärd D, Erfurth EM, Hellerstedt R et al (2022) Cognitive interference processing in adult survivors of childhood acute lymphoblastic leukemia using functional magnetic resonance imaging. Acta Oncol Madr 61:333–340. https://doi.org/10.1080/0284186X.2021.1987514/SUPPL_FILE/IONC_A_1987514_SM6514.PNG

    Article  Google Scholar 

  24. Bryant AL, Walton AML, Shaw-Kokot J et al (2015) Patient-reported symptoms and quality of life in adults with acute leukemia: a systematic review. Oncol Nurs Forum 42:E91. https://doi.org/10.1188/15.ONF.E91-E101

    Article  PubMed Central  Google Scholar 

  25. Hjermstad MJ, Knobel H, Brinch L et al (2004) A prospective study of health-related quality of life, fatigue, anxiety and depression 3–5 years after stem cell transplantation. Bone Marrow Transpl 34:257–266. https://doi.org/10.1038/sj.bmt.1704561

    Article  CAS  Google Scholar 

  26. Esser KP, Mehnert A et al (2017) Depression and anxiety following hematopoietic stem cell transplantation: a prospective population-based study in Germany. Bone Marrow Transpl 52:1651–1657. https://doi.org/10.1038/bmt.2017.190

    Article  Google Scholar 

  27. Ghazikhanian SE, Dorfman CS, Somers TJ et al (2017) Cognitive problems following hematopoietic stem cell transplant: relationships with sleep, depression and fatigue. Bone Marrow Transpl 52:279–284. https://doi.org/10.1038/bmt.2016.248

    Article  CAS  Google Scholar 

  28. Chang G, Orav EJ, McNamara TK et al (2005) Psychosocial function after hematopoietic stem cell transplantation. Psychosomatics 46:34–40. https://doi.org/10.1176/appi.psy.46.1.34

    Article  PubMed  Google Scholar 

  29. Park S, Choi E, Kyung Kim IR et al (2019) Comparison of quality of life and depression between hematopoietic stem cell transplantation survivors and their spouse caregivers. Blood Res 54:137–143. https://doi.org/10.5045/BR.2019.54.2.137

    Article  PubMed  PubMed Central  Google Scholar 

  30. Kroemeke A, Sobczyk-Kruszelnicka M, Kwissa-Gajewska Z (2018) Everyday life following hematopoietic stem cell transplantation: decline in physical symptoms within the first month and change-related predictors. Qual Life Res 27:125–135. https://doi.org/10.1007/S11136-017-1705-3/FIGURES/4

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank the staff of Rajiv Gandhi Cancer Institute and Research Centre, New Delhi for permitting us to carry out this research

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Centre for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, 110062, India

    Rhythm Joshi, Aakriti Garg, Zehva Khan,  Nidhi & Mohd Ashif Khan

  2. Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India

    Aakriti Garg

  3. Department of Hemato-Oncology and Bone Marrow Transplantation, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, 110085, India

    Dinesh Bhurani

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  1. Rhythm Joshi
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  2. Aakriti Garg
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  4. Dinesh Bhurani
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  5. Nidhi
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Contributions

RJ: Design, Conducted study, manuscript writing AG: Data analysis and manuscript writing ZK: Design, Conducted study, manuscript writing DB: Design, Data analysis, Editing Nidhi: Manuscript writing and editing M. AK: Design, Conceptualization of idea, data analysis, final manuscript writing and editing.

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Correspondence to Mohd Ashif Khan.

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Informed consent was obtained from each participant prior to inclusion in the study.

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The study had been approved by the Institutional Review Board (IRB) (REF/2019/12/030223).

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Rhythm Joshi and Aakriti Garg share equal authorship in this paper.

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Joshi, R., Garg, A., Khan, Z. et al. Short-Term Impact of Hematopoietic Stem Cell Transplantation on Depressive Behavior, Cognition and Quality of Life in Leukemia Patients. Indian J Hematol Blood Transfus 40, 83–90 (2024). https://doi.org/10.1007/s12288-023-01653-2

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